The following case from Brill’s experience corroborates the assumption that even serious mistakes are determined by unconscious intentions: “A physician received a telegram informing him that his aged uncle was very sick. In spite of important family affairs at home he at once repaired to that distant town because his uncle was really his father, who had cared for him since he was one and a half years old, when his own father had died. On reaching there he found his uncle suffering from pneumonia, and, as the old man was an octogenarian, the doctors held out no hope for his recovery. ‘It was simply a question of a day or two,’ was the local doctor’s verdict. Although a prominent physician in a big city, he refused to co-operate in the treatment, as he found that the case was properly managed by the local doctor, and he could not suggest anything to improve matters. “Since death was daily expected, he decided to remain to the end. He waited a few days, but the sick man struggled hard, and although there was no question of any recovery, because of the many new complications which had arisen, death seemed to be deferred for a while. One night before retiring he went into the sick-room and took his uncle’s pulse. As it was quite weak, he decided not to wait for the doctor, and administered a hypodermic injection. The patient grew rapidly worse and died within a few hours. There was something strange in the last symptoms, and on later attempting to replace the tube of hypodermic tablets into the case, he found to his consternation that he had taken out the wrong tube, and instead of a small dose of digitalis he had given a large dose of hyoscine. “This case was related to me by the doctor after he read my paper on the Œdipus Complex.[49] We agreed that this mistake was determined not only by his impatience to get home to his sick child, but also by an old resentment and unconscious hostility toward his uncle (father).” It is known that in the more serious cases of psychoneuroses one sometimes finds self-mutilations as symptoms of the disease. That the psychic conflict may end in suicide can never be excluded in these cases. Thus I know from experience, which some day I shall support with convincing examples, that many apparently accidental injuries happening to such patients are really self-inflicted. This is brought about by the fact that there is a constantly lurking tendency to self-punishment, usually expressing itself in self-reproach, or contributing to the formation of a symptom, which skilfully makes use of an external situation. The required external situation may accidentally present itself or the punishment tendency may assist it until the way is open for the desired injurious effect.